Exploring oral health care needs of Canadians with rheumatic diseases: a qualitative study

Patients with rheumatic diseases (RD) have a high prevalence of oral manifestations and/or oral side effects from immunomodulatory medications. This study used qualitative methods to explore how patients with RD perceive their oral health, to describe how patients and their health care providers (HCPs) approach oral care and any related challenges, and to determine the preferences of patients and HCPs for receiving oral health information.

Virtual semi-structured interviews were conducted with HCPs and patients with RD. Interview transcripts were analyzed thematically, using a grounded theory approach.

Theme saturation was achieved after interviewing 9 patients with RD (all female, age range 57 to 73 years) and 3 HCPs (adult rheumatologist, pediatric rheumatologist, and an oral medicine and oral pathology dental specialist). On average, interviews lasted 23 minutes. Four themes were identified: 1) oral health and care perception; 2) oral health requires creativity and commitment; 3) communication on oral health and RD: barriers and solutions; 4) need for change in the model of care. Patients perceived substantial challenges with oral health self-management and professional oral health care, used multiple oral care products, felt existing educational resources were limited, and suggested a multipronged communication strategy to deliver educational material. HCPs recommended greater interdisciplinary communication. Both patients and HCPs proposed an interprofessional approach to RD and oral health care.

Patient- and provider-informed, evidence-based oral health and dental management guidelines and educational tools that are relevant to patients with RD are needed. Multidisciplinary care models may improve the oral health of patients with RD.